tretinoin and Periodontitis

A T-helper 17 (Th17)/regulatory T (Treg) imbalance has been suggested recently to play a role in the development of periodontitis. All-trans retinoic acid (ATRA) has been reported to modulate Th17/Treg imbalances in some diseases. However, the effect of ATRA on periodontitis remains unknown. This study observes the effect of ATRA on Th17/Treg imbalance modulation in experimental periodontitis.. Experimental periodontitis was induced in mice by oral infection with Porphyromonas gingivalis (P. gingivalis). ATRA was orally administered every other day. Alveolar bone resorption (ABR) was estimated by measuring the distance from the cemento-enamel junction to the alveolar bone crest. CD4(+) T-cell subsets in the cervical lymph nodes (CLNs) and spleen were analyzed by flow cytometry. Th17/Treg cell-related cytokine messenger ribonucleic acid expression was quantified by real-time reverse transcription-polymerase chain reaction.. The present data shows that ATRA suppressed ABR and inhibited inflammatory cell infiltration into periodontal tissues. These effects were closely associated with reduced CD4(+) retinoid-related orphan receptor γτ(+) cells and increased CD4(+) forkhead box P3(+) cells in the CLNs. Furthermore, ATRA downregulated interleukin (IL)-17A expression and upregulated IL-10 and transforming growth factor-β1 expression in both the CLNs and P. gingivalis-infected gingival tissues.. These results suggest that ATRA modulation of the Th17/Treg imbalance provides protection against periodontitis by enhancing Treg cell activation and inhibiting Th17 cell activation. These results indicate the potential for clinical prevention of periodontitis.

Topics: Administration, Oral; Alveolar Bone Loss; Animals; Anti-Inflammatory Agents; CD4-Positive T-Lymphocytes; Disease Models, Animal; Female; Forkhead Transcription Factors; Interleukin-10; Interleukin-17; Lymph Nodes; Lymphocyte Activation; Mice; Mice, Inbred C57BL; Mice, Inbred Strains; Nuclear Receptor Subfamily 1, Group F, Member 3; Periodontitis; Porphyromonas gingivalis; Random Allocation; Spleen; T-Lymphocytes, Regulatory; Th17 Cells; Transforming Growth Factor beta1; Tretinoin

Four siblings affected by Papillon-Lefèvre syndrome (PLS) ranged in age from 2 to 11 years. The parents were unaffected and parental consanguinity was present. The 2-year-old girl showed the early manifestations of PLS; that is, slight gingival swelling and erythema occurring simultaneously with minimal scaling of palms and soles. The other siblings, aged 5, 8, and 11 years, showed severe periodontopathy with tooth loss and marked palmoplantar keratoderma with a centripetal extension of the keratoses to the limbs and trunk. These three older siblings were treated with acitretin (Ro 10-1670), the free acid of etretinate, with complete clearing of the skin and healing of gingival pockets. Treatment was given for 16 months; teeth that erupted during therapy were free of periodontopathy and remained firmly anchored to the alveolar bone. In two of the children ultrastructural examination of involved skin was performed before and during acitretin treatment. Before treatment a large number of lipidlike vacuoles were found in corneocytes and in granulocytes; tonofilaments were reduced in number, and keratohyaline granules frequently showed a rectangular or globular shape. During treatment with acitretin these abnormalities diminished markedly. Thus, etretin is effective in treating PLS and, if treatment is started at an early age, should allow patients with PLS to have normal adult dentition.

Topics: Acitretin; Biopsy; Bone Development; Child; Child, Preschool; Consanguinity; Diagnosis, Differential; Female; Gingivitis; Humans; Keratoderma, Palmoplantar; Male; Papillon-Lefevre Disease; Pedigree; Periodontitis; Skin; Tretinoin